What About Mum?

There are some things in life that I don’t think anyone can really prepare you for, and having your first baby is definitely one of them.

You can read the books, go to the classes and listen to friends and family telling you their birth stories — sometimes in considerably more detail than you might have wanted. You can make plans about how you are going to feed your baby, where they are going to sleep and what sort of parent you think you are going to be.

And then you actually have a baby, and realise that knowing what is supposed to happen and living it are two completely different things.

I had perhaps seen more of childbirth than most women having their first child. I was a doctor and had spent time working on call on labour wards. I had seen women arrive with carefully thought-out birth plans, only for circumstances to take over. I had seen frightened and exhausted women, labours that suddenly became very medicalised, decisions having to be made quickly and instrumental deliveries when things hadn’t gone according to plan.

Perhaps because I had seen so much of that, when I was pregnant with Becca, my first daughter, I was absolutely adamant that I wanted something different. I wanted to give birth at home and, if possible, I wanted a water birth.

Some of my friends were horrified. Others told me I was incredibly brave.

I’ve been called brave at various points in my life, but I never really saw it that way. Women have been giving birth at home for generations and, across much of the world, they still do. There are women who travel considerable distances with very little support to give birth and cultures where women have traditionally gone away to labour and give birth alone.

That is brave.

Choosing to have my baby in familiar surroundings, with people I trusted and access to medical help if I needed it, didn’t feel particularly brave to me. If anything, I think my decision came from wanting to retain some control, or perhaps more accurately, not wanting that control taken away from me.

I knew, of course, that sometimes intervention was absolutely necessary. I had seen enough to understand exactly why it could be. But if everything remained straightforward, I didn’t want intervention to be my starting point.

When I spoke to my NHS midwife about the birth I wanted, she was very honest with me. She couldn’t guarantee that a birthing pool would be available when I went into labour, or that she would be the midwife looking after me. For me, that continuity mattered enormously.

So at around 28 weeks I decided to use a private midwifery service. From then on I had two midwives who really got to know me. I had plenty of antenatal visits at home, which meant my family became involved too, and I knew that the people who would eventually be with me when I gave birth understood me, understood what I wanted and, importantly, knew when medical intervention might be necessary. I trusted that if we did need secondary care, they would advocate for me.

Their birthing unit wasn’t really a unit at all. It was essentially a house with a couple of bedrooms, right next to St George’s Hospital. For me, it felt like the best of both worlds.

And I did get the birth I had hoped for. Becca was born naturally, in water and without pain relief.

That neat little sentence, however, doesn’t really convey what had come before it.

I had been having false starts for three days and three nights and had barely slept. By the time I actually gave birth, I was completely exhausted. Afterwards my blood pressure dropped so low that initially I couldn’t even stand up. Once I eventually could, all I wanted to do was go home.

Within about six hours of giving birth we were back at my parents’ house, and I went straight to bed. Not just any bed, but my old bed, in the bedroom I had grown up in. I left this tiny new person in the spare room next door with my husband and told him to wake me if she needed feeding.

He spent most of that first night holding her because he wasn’t quite sure what else he was supposed to do with something so small.

It makes me smile now. There we were, a doctor who had worked on labour wards and a new father sitting up all night holding his daughter because he didn’t know where to put her. Between us we had plenty of education, plenty of life experience and, in my case, quite a lot of medical knowledge, and yet neither of us had ever done this before.

Breastfeeding was another lesson.

Becca was small and struggled to latch. I desperately wanted to breastfeed and had always hoped that, if I could, I would continue for as long as possible, but those first few days were incredibly hard. It hurt and she seemed to want to feed all the time. I came very close to giving up.

What made the difference was having someone there.

The midwives came to see me almost every day after Becca was born. They didn’t simply ask whether she was feeding and tick a box. They sat with me while I cried trying to feed her, they watched me feed her, helped me position her and showed me how to encourage this tiny baby to latch properly. Then they came back and did it again.

They had time, and that time made all the difference. They told me that by week six everything would just click-and it did for me.

Looking back, I am quite certain that without their support I would have not got to week six. Instead, gradually, we got there and, once we did, I loved it. I went from almost giving up in those first few days to breastfeeding Becca until she was around two years old.

It wasn’t that I suddenly became more determined. I had wanted to breastfeed from the beginning. The difference was that somebody supported me long enough for me to get through the difficult bit.

And feeding wasn’t the only thing I needed help with.

Going back to my parents’ house after Becca was born turned out to be one of the best things we could have done. We only lived two roads away, but we stayed with them for six weeks. There was always another pair of hands, someone to make something to eat, someone to hold the baby and someone to reassure us that what we were doing was probably all right.

I needed that reassurance far more than I might have imagined.

For the first couple of weeks, I was actually frightened to change Becca’s nappy. She seemed so incredibly small and fragile that I was scared of doing something wrong. My husband, meanwhile, was amazing. He was much braver than I was and simply got on with things.

Eventually, of course, he had to go back to work and I knew I had to learn to do these things myself. And so I did.

There is something quite humbling about being a doctor, having looked after hundreds of patients and worked on labour wards, and then finding yourself slightly terrified of changing your own baby’s nappy. Medical knowledge doesn’t necessarily prepare you for motherhood.

When we eventually felt ready to go back to our own home, my parents didn’t disappear simply because we had moved two roads away. They came over almost every day to see me and Becca. At the time I don’t think I fully appreciated just how important that was.

I do now.

We quite rightly talk about physical recovery after childbirth, feeding, sleep and mental health, but there is another part of postnatal care that is much harder to measure: connection.

Having somebody there matters.

Someone who notices you haven’t eaten. Someone who holds the baby while you have a shower. Someone you can hand a crying baby to when you’ve run out of ideas. Someone who tells you that you’re doing all right when you’re not entirely convinced yourself.

I was incredibly fortunate to have that, and perhaps I appreciate it even more because over the years as a GP I have met so many women who haven’t.

I’ve looked after new mothers whose partners have had to return to work and who suddenly find themselves alone for most of the day with a new baby. Women whose parents and families live overseas. Women who have moved here and don’t yet have a network around them. Women who speak very little English and are trying to navigate not only motherhood, but an unfamiliar health system and an unfamiliar country. And women bringing up their babies alone.

I have often thought about those women and wondered what those long days must feel like.

Because even with a supportive husband, parents two roads away, midwives visiting and all the advantages of being medically trained, there were moments when I found being a new mother daunting.

What must it be like when there really is no one?

And then there were three

Becca didn’t stay an only child for very long. Jake followed 22 months later and Evie two and a half years after that, and by then I was a very different mother.

Somewhere along the way I had stopped being frightened of nappies and worrying quite so much about whether I was doing everything correctly. I became more confident, more relaxed and much more trusting of my own instincts. There was something wonderfully liberating about that.

I had three very small children, which sounds slightly chaotic when I write it now — and I’m sure at times it was — but I loved those years.

I went on to have both Jake and Evie at home, in water and without pain relief. Evie was actually born in the house we still live in today, in a birthing pool in what is now our dining room.

It was an amazing experience, although she did give us all one rather dramatic surprise.

Nobody knew she was breech.

When her legs appeared instead of her head, I remember the atmosphere in the room changing. There was suddenly tension and talk of calling an ambulance and transferring me to hospital. In the middle of all of that, I refused.

Evie was born there in our dining room. She was tiny and with a slight delay delivering her head, she needed oxygen immediately afterwards, which she received lying on the dining-room floor beside the birthing pool.

Thankfully, she was absolutely fine.

It certainly wasn’t the calm water birth we had all been anticipating, but perhaps by my third baby I had learnt something that I hadn’t understood when I was preparing so carefully for Becca. You can make all the plans in the world, but childbirth — rather like parenthood itself — doesn’t always read the plan.

By then I was much more comfortable with that. I had gone from being the first-time mother who thought that knowing about childbirth might somehow prepare me for it, to a mother of three who understood that so much of parenting is simply learning as you go.

The confidence I eventually developed didn’t appear from nowhere.

I had been supported into it.

Looking back as a GP

Years later, sitting on the other side of the desk doing postnatal checks as a GP, I have often thought back to those first weeks of my own motherhood.

Postnatal checks in the NHS can feel incredibly rushed. That isn’t because GPs don’t care. It is simply the reality of trying to cover an enormous amount in a very limited appointment.

There is the physical recovery from pregnancy and birth, blood pressure, bleeding, Caesarean wounds or perineal tears, pelvic floor symptoms, feeding and contraception. But what about sleep and exhaustion? Anxiety? Relationships? Sex? How a woman feels about her body? Whether she has anyone helping her? Whether she is frightened, lonely or simply completely overwhelmed?

And what about the birth itself?

Over the years I have sat with women who have been deeply affected by what happened to them during childbirth. A difficult labour, an emergency Caesarean, an instrumental delivery, a haemorrhage, a baby needing unexpected medical care, or simply the frightening feeling that events took over, decisions were happening around them and the birth they had imagined disappeared completely.

We can describe these things clinically and say that mother and baby are well, but that doesn’t necessarily mean that Mum is all right.

I have seen women months later who can still replay their delivery in extraordinary detail. Women who become tearful talking about it. Women who feel guilty because they have a healthy baby and think that somehow means they shouldn’t feel traumatised by the way that baby arrived.

And sometimes there isn’t even a baby to bring home.

I think particularly of women who lose a baby late in pregnancy or around the time of birth. Their bodies have still been through pregnancy and sometimes labour. Their hormones still change. Their breasts may still produce milk. They are physically recovering at the same time as experiencing an unimaginable loss.

Yet the very absence of the baby can sometimes mean that the woman herself becomes almost invisible.

She still needs care. Perhaps more than ever.

What about Mum?

There is another transition that I don’t think we talk about enough.

The moment I had a baby, I became Mama.

It is extraordinary how quickly that new identity takes over. People who would once have asked how you were now ask how the baby is. Conversations revolve around feeding and sleeping and nappies. Your days and nights are organised around someone else’s needs and, quite naturally, that tiny person’s wellbeing becomes more important to you than your own.

In many ways, I think that is exactly as it should be. Becoming a parent changes your priorities profoundly, and I wouldn’t have wanted it any other way.

But there is still a transition involved.

The woman who existed before the baby hasn’t disappeared.

She may have been a doctor, a teacher, a lawyer, a student, a friend, a partner, a daughter. She had interests and routines, a relationship, a body she recognised, a social life and a sense of who she was. Then, almost overnight, Mum becomes the identity that seems to define her and everything that came before moves into second place.

That can be wonderful.

It can also sometimes be hard.

You can adore your baby and still miss parts of your old life. You can feel incredibly grateful and still be exhausted. You can love being a mother and occasionally miss the person you were before you became one.

Those things are not contradictory.

And while all of that emotional adjustment is happening, your body has changed, your sleep has changed, your relationship may have changed and sex may feel different. Your confidence can change and your sense of yourself can change, all while you are learning how to care for another human being.

No book can really prepare you for that.

I was fortunate. I had my husband, my parents and midwives who knew me and had time for me. Looking back now, I can see just how much that support shaped those early weeks and months and helped me become the confident mother I eventually became.

Not everybody has that.

After more than thirty years in medicine, I don’t think we should underestimate what a difference early support can make. Sometimes the questions we need to ask aren’t particularly complicated.

Who is looking after you? Who can you call after a terrible night? Who holds the baby while you have a shower? Who notices when you’re struggling before you have to say it? And who asks how you are — and actually has the time to hear the answer?

Supporting a mother doesn’t make motherhood easy, but it can make everything else that little bit easier.

Perhaps, amongst all the questions we quite rightly ask about a new baby, there is one more that deserves a little more time.

What about Mum?

If you enjoyed reading this, you can find more of my reflections on life, health and medicine in my other posts.

If this piece resonated with you, you can also find out more about the What About Mum? Trinity Postnatal Check — a dedicated postnatal health assessment giving women the time and space to focus on their own health and wellbeing after having a baby.

Find out more about the What About Mum? Postnatal Check →